Article excerpt

BACKGROUND: The reliability and validity of various Objective Structured Clinical Examinations (OSCEs) have been well documented in the medical and nursing literature. The purpose of this study was to examine the effect of exam preparation methods on student performance and student satisfaction for an OSCE used to assess doctoral physical therapist students. Subjects: Sixty-five physical therapist students from two post-professional physical therapist programs were randomized to a rubric exam preparation group and a nonrubric exam preparation group for a musculoskeletal OSCE. METHODS: The OSCE was a midterm practical exam for a peripheral joint musculoskeletal course. Upon completion of the exam, all students completed a post-exam satisfaction survey. RESULTS: The results of the 2 × 2 ANCOVA that examined performance and satisfaction on the OSCE indicated a significant interaction between the group assignment and program, p<0.028, for performance, and that satisfaction scores between the rubric and nonrubric groups and program were not significant for any of the questions asked on the post-examination survey. CONCLUSION: Despite the reported benefit of utilizing rubrics, the findings of this study did not show a difference in student performance or satisfaction when using a rubric to prepare for an OSCE. J Allied Health 2013; 42(4):214- 222.

OBJECTIVE STRUCTURED CLINICAL EXAMINATIONS (OSCEs) are a part of the assessment process of clinical competency in medicine and nursing.1-9 Beginning in the 1990s, physical therapy education incorporated the OSCE in the evaluation of student competency of clinical skills, and it is a component of the licensure examination for Canadian physical therapists.10,11 The OSCE format, in contrast to a written exam, appears to be a good fit for evaluating clinical competence in physical therapist education, as the exam requires the students to demonstrate their clinical reasoning skills in a simulated clinical situation. The OSCE includes examination of communication skills, and the objective nature of the exam enables the faculty to give feedback based on evidence of performance.9,12-14

The reliability and validity of various OSCEs used in medical and nursing academic programs have been well documented.1,2,5,6,9,15,16 The results of studies in the medical and nursing professions examining inter-rater reliability report reliability coefficients ranging from 0.80 to 0.99.2,5,6,15,17 In addition, internal consistency of the OSCE exam has been examined and the studies reporting acceptable values (Cronbach's α >0.60 and <0.90) administered high station OSCEs, 26-38 stations, or low station OSCEs, 3-8 stations, with different case scenarios at each station.1,18-25 Unlike the medical and nursing literature which contains numerous studies on the reliability of an OSCE, few studies have examined the reliability of an OSCE in entry-level physical therapist education. 25,26 The musculoskeletal OSCE used in the Wessel et al. study26 consisted of 8 stations with a different case scenario at each station and had poor internal consistency. In contrast, the Gorman et al. study25 demonstrated good internal consistency evaluating a neuromuscular OSCE that consisted of 8 stations, with 4 stations based on one case scenario (SP interactions) and 4 stations using four different scenarios (written/ video case scenarios).

Additionally, it has been reported in the medical literature that students have been satisfied with the general organization of the OSCE and the opportunity to be evaluated on clinical competence in a clinical situation. 13,14,27 However, these same students are less satisfied with the anxiety associated with taking the exam and the amount of time needed to complete the exam.13,14,27 In light of these factors, student performance and satisfaction with this type of exam format may be enhanced by the development of strategies to prepare students for the OSCE. Currently, no studies in medicine, nursing, or physical therapy report the effects of differing exam preparation methods on student performance and student satisfaction of an OSCE. …